Hi friends! Do you know the reasons behind training your pelvic floor muscles (PFM)? Well ideally, the PFM automatically do the right thing at the right time. However, due to trauma, disease, or functional causes, the PFM may not function automatically as they were designed to do. This can result in pain, leaks, pressure, difficulty in the bathroom, difficulty in the bedroom, and more!
But there is good news friends! Most of the time they can be retrained to do the right thing! Ideally, visiting with a pelvic physical or occupational therapist will help to train your pelvic floor properly. We do realize that there might be several reasons that could stop you from getting to a trained therapist (like money, access to a therapist, or lack of child care). So, this week we are going to talk about 5 common mistakes when doing PFM training on your own at home.
#1: Squeezing the wrong muscles or extra muscles
When you start training the PFM you want to be able to identify and isolate them. Sometimes we don’t just squeeze the PFM and we add the inner thighs, hips, buttocks, and/or belly muscles. Keep these other muscles quiet if you can, although this may take some practice. It can help to use cues to contract the pelvic floor, some of our favorites are below.
#2: Straining or holding your breath
The pelvic floor (along with your diaphragm and belly muscles) should be able to move freely. As you contract the pelvic floor avoid holding your breath and trying to push. Instead, as you breath in, let the PFM relax and lower. As you breath out, gently squeeze the PFM to lift them and close the openings. Learning to control and coordinate your breath with movement not only helps the pelvic floor, but can help in regulating your entire body.
#3: Training in the wrong starting position
The position you are in can make it easier or harder to contract your PFM. If you are weak or have a very hard time, starting in a position lying down with your hips elevated can be a great place to start. This position lets gravity help gently pull on the PFM to help them contract. To make it harder, try the following progressions:
Lying flat on your back
Reclined position (use pillows to prop your back up)
Sitting
Standing
When sitting or standing, the pelvic organs place weight on the pelvic floor that it must lift against. Normally, the PFM are strong enough to contract while lifting these organs, but when the PFM aren’t working properly, sometimes this weight can be too much.
#4 Performing in isolation only
Keep in mind, while we can train the PFM while sitting or lying down, they were designed to support our bodies as we move! Once you know how to contract the muscles properly, it’s important to integrate them into functional activities like picking up objects, squatting, or jumping. A pelvic therapist is a great resource to helping you train the PFM during functional activities.
#5 Practicing quick flicks only
Often when training the PFM, we focus on quickly contracting the muscles. Quick contractions are good for strength and important to help avoid issues like stress incontinence. But there are two other important things to train the PFM to do: endurance holds and relaxing.
The PFM need to have good endurance so they are not tired at the end of the day and can sustain longer activities. Practice contracting the PFM and holding for up to 10 seconds at a time. You might find that you can only hold for a few seconds before you start to lose the strength of the contraction, but that’s okay, start with what you can and slowly increase the amount of time you hold contractions. Be sure not to squeeze other muscles as you squeeze the PFM.
As important as it is to contract the PFM, it’s just as important to learn how to let them relax! Contracting the muscles over and over without relaxing them can lead to weakness, pelvic pain, and other issues. Between each contraction, make sure you are allowing the PFM to return to the starting position before contracting again. If you are practicing endurance holds, let the PFM relax for 10 seconds in between each contraction.
It’s important to note that PFM contractions (or Kegel exercises) aren’t the only way to strengthen them. Seeing a pelvic floor physical therapist can help fix other problems (like hip, knee, back, or ankle issues) that might be contributing to your pelvic symptoms.
Here are some great resources to help you learn more about your PFM:
Ask your healthcare provider for a referral to a pelvic therapist.
Find a pelvic therapist on your own at myPFM.com. We have links to 4 free searchable databases under Find a PT.
Watch the our YouTube playlist on PFM Training
Learn more about the pelvic floor muscles with our book: My Pelvic Floor Muscles The Basics
Sign up for our email newsletter!
Visit our Amazon store for some of our favorite pelvic health products.
For providers, check our online courses to help your clients train their PFM. Consider joining our Ambassador Program and most of our courses are included with your membership!
Evidence Based Use of Vaginal Weights in Pelvic Rehabilitation with Amanda Olson, PT, DPT, PRPC
The Hip and Urinary Incontinence: A look at what keeps us dry with Lauren Trosch, PT, DPT, OCS
Nocturnal Enuresis with Dr. Charley Peterson, PT, DPT
An Innovative Way to Use Internal Electrical Stimulation for Severe Pelvic Floor Dysfunctionwith Elizabeth Makous, MSPT, CLT, PRPC, CES
Urinary Incontinence and Urogynecology with Dr. Tessa Krantz, MD
Written by Emily Reul, PT, DPT